This proposal seeks support to study possible relations between breast implants (BI) and autoimmunity. The medical literature has anecdotal reports of breast implantation followed by autoimmune phenomena and disease. Scleroderma is the condition most frequently mentioned. As there is a short list of environmental agents associated with scleroderma, it is possible that breast implants might be included in that list. No comprehensive study of the relation of BI to autoimmunity has been made. Preliminary data indicate an increased prevalence of antinuclear antibodies (ANA) in women with BI. A comprehensive cross-sectional survey is needed to expand these findings. Patients will be identified in the following categories: 1a. Bl with diagnosed connective tissue disease 1b. Connective tissue disease (CTD) without Bl 11a. Bl with multiple symptoms but no definite diagnosis (sometimes called unclassified CTD) 11b. Similar patients without Bl 111a. Bl, feeling healthy 111b. No implants. feeling healthy Patients will all complete a detailed questionnaire giving information about health, Bl, surgery, etc., and will have a physical exam. Blood will be drawn for ANA, quantitative immunoglobulins, HLA typing, T and B cell phenotyping, response to heat shock proteins. A "blind" forearm skin biopsy will be studied by immunohistochemistry for endothelial activation, procollagen production, expression of stem-cell factor and c-kit, etc. Multivariate analysis will be performed to discover what (if any) historical, physical or immunological variables are associated with Bl, comparing and contrasting the a and b subgroups in categories I, II, and III.